The meeting of DGMOsConstructive India-Pakistan engagement mustThe
agreement reached between the directors general of military operations (DGMO) of India and Pakistan expressing ‘resolve and commitment for ensuring ceasefire, peace and tranquillity’ along the Line of Control (LoC) in Jammu and Kashmir and ‘to re-energise the existing mechanisms’ is a welcome step.

Awareness the antidoteIndigenous device holds out hope on thalassaemiaMarriages
between people from different backgrounds and geographical regions have broken many social barriers. But they have also resulted in the presence of thalassaemia on a pan-India basis. Earlier the number of thalassaemic children was limited and was restricted to a few regions. Now, by a rough estimate, 12,000 children are born every year suffering from the eight major thalassaemia mutations; many more go unreported.

The dialogue way
India, Pakistan need to tone down the rhetoric, set stage for talks
Kuldip NayarPAKISTAN Prime Minister Nawaz Sharif has repeatedly asked India to resume talks which had got snapped following the terrorists’ attack on Mumbai in November 2008. His brother, Chief Minister of Pakistan’s Punjab Shahbaz
Sharif, echoed the same sentiments during his visit to India’s Punjab a few days ago. His advice to both the countries was to engage in dialogue to settle their issues since war is no longer an option.

SOS: Save our stuff
Madhumita GuptaIs
it only me or does everybody have a polythene bag full of other polythene bags somewhere in the house?’ This question came up the other day on one of the emails doing the rounds. I could only sheepishly nod. I mean how can you just throw away a perfectly good polythene bag? Plus, what is more practical? The polythene bag which can be used ‘n’ number of times or the unreliable paper bag that can let you down at the most crucial time? Ever since a sturdy looking paper bag let a gobhi-aloo lunch leak an oily map of Africa on my new jeans, I haven’t quite forgiven it.

Healthcare for veterans, by veterans
Under the Ex-servicemen’s Contributory Health Scheme, one polyclinic has been opened in every district of the country. But a lot more needs to be done to help the growing community of defence veterans
Brig M.L. Kataria (retd)A historic decision was taken by the Government of India, Ministry of Defence, in December 2002 to provide comprehensive health care to 10 million ex-servicemen and their entitled dependants, through Ex-servicemen’s Contributory Health Scheme (ECHS), which was launched in January 2004. There is no parallel to this gigantic healthcare project for ex-servicemen and their entitled dependants.

The
agreement reached between the directors general of military operations (DGMO) of India and Pakistan expressing ‘resolve and commitment for ensuring ceasefire, peace and tranquillity’ along the Line of Control (LoC) in Jammu and Kashmir and ‘to re-energise the existing mechanisms’ is a welcome step. The two sides have also agreed to hold two additional brigadier-level flag meetings and to make the hotline between the two DGMOs ‘more effective and result oriented’ in addition to informing each other of any inadvertent crossings by civilians.

These confidence building measures, discussed in a rare meeting between the two DGMOs on the Pakistani side of the Attari-Wagah border on Tuesday, came three months after Prime Minister Manmohan Singh and his Pakistani counterpart Nawaz Sharif agreed at a meeting in New York last September to reduce tensions on the ever fragile LoC, which has witnessed about 200 incidents of ceasefire violation this year alone. Despite an understanding reached in November 2003 to silence the guns along the LoC and the Actual Ground Position Line in the Siachen glacier region, the last three years have witnessed a gradual escalation in tensions along the various types of borders that divide J&K from Pakistan Occupied Kashmir.

It would have been preferable if the 10-year-old ceasefire understanding had not been violated in the first place and immediate remedial measures had been taken to de-escalate tensions in the initial stages itself. Peace and tranquillity along the LoC ought to now be a given. Both countries are known to have well established and hardened positions over Jammu and Kashmir that date back 66 years, a period that has witnessed four wars, numerous skirmishes, death of hundreds of soldiers and civilians and sharp diplomatic and political exchanges. Let the DGMOs’ meeting be the beginning of some constructive engagement aimed at significantly improving bilateral relations. Maybe when sufficient bonhomie and trust is built and time has elapsed the two sides will be able to listen and resolve all outstanding festering and contentious territorial issues.

Marriages
between people from different backgrounds and geographical regions have broken many social barriers. But they have also resulted in the presence of thalassaemia on a pan-India basis. Earlier the number of thalassaemic children was limited and was restricted to a few regions. Now, by a rough estimate, 12,000 children are born every year suffering from the eight major thalassaemia mutations; many more go unreported. It is an inherited condition affecting the blood that requires lifelong treatment and monitoring. A child will be thalassaemic if both parents carry the particular gene mutations. The birth of thalassaemic child can thus be avoided if potential parents take a simple test to check for the condition.

The testing, however, is not happening, as is evident from the fact that the number of such children being born has risen over the years. The reason is lack of awareness and the high cost of tests, varying from Rs 4,000 to Rs 20,000. Now, a kit developed indigenously by the Indian Council of Medical Research in association with the National Institute of
Immunohaematology, which costs only Rs 400, can test all eight mutations in one go. The kit’s relevance cannot be
overemphasised, as preventing the birth of such children is the only way to check this disease, as almost no cure is available for
thalassaemia. The only remedy available — getting the right donor for a bone marrow transplant — is fraught with complications and the success rate remains awfully low at 3 to 5 per cent.

Affected children have to go through regular blood transfusion, which puts them at the risk of HIV infection. A large number of blood banks still use the ELISA test for HIV, which is not 100 per cent accurate, rather than the more reliable Nucleic Acid Testing. This results in nearly 3,000 thalassaemic children getting infected with HIV annually. All this suffering can be avoided if an awareness drive is launched about the disease and the new economical test kit that can screen high-risk couples to save them from a life of misery.

Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed.
— Dwight D. Eisenhower

NEW DELHI (UNI): Nearly 13,000 students in the first and second year classes in engineering colleges in the country will be covered by the compulsory military training programme of the National Cadet Corps from the next academic session. The total number of students in these classes is nearly 30,000, of whom about 17,000 are already in the N.C.C. When military training was made compulsory for all able-bodied male college students in July last, all the engineering students could not be included in the programme because of non-availability of equipment for raising the technical units. Some of them were, therefore, included in the basic infantry training given to all students. It was, however, felt that engineering students would derive greater benefit from the N.C.C. if they were included in technical units. It will now be possible to do so by raising a sufficient number of such units so as to cover all the engineering students.

CHANDIGARH: Mr. Keshab Chandra Basu, Speaker of the West Bengal Assembly, said today that “Heroism, prowess, wealth and prosperity, do not leave any marks behind but the marks that are left by culture are imperishable.” Mr. Basu was delivering his presidential address at a meeting of the Society and Culture Section of the All-India Bengali Literary Conference held under the auspices of the Punjab Kala Akademy at Tagore Theatre. According to Mr. Basu, society and culture were two words that were inseparably connected with each other. One could not be conceived without the other. The character of the society was to be found indicated in its culture and culture developed through the society.

The dialogue way
India, Pakistan need to tone down the rhetoric, set stage for talks
Kuldip Nayar

The DGMOs of Pakistan and India, Maj Gen Aamer Riaz (right) and Lt Gen Vinod Bhatia, before a meeting at the Wagah-Attari border on Tuesday. PTI

PAKISTAN Prime Minister Nawaz Sharif has repeatedly asked India to resume talks which had got snapped following the terrorists’ attack on Mumbai in November 2008. His brother, Chief Minister of Pakistan’s Punjab Shahbaz
Sharif, echoed the same sentiments during his visit to India’s Punjab a few days ago. His advice to both the countries was to engage in dialogue to settle their issues since war is no longer an option.

India’s External Affairs Minister Salman
Khurshid, too, has said that he is not against dialogue. But he has predicated his statement with a proviso that there should be an environment for the talks to be fruitful. He has probably in mind the contentious issues which continue to sour relations between the two. One irritant is the attack on Mumbai. The manner in which Pakistan has gone about in not punishing the perpetrators shows that it is merely going over the exercise. The suit in the law court is still in the initial stages even after five years. Numerous judges hearing the case have been either transferred or probably asked to go on leave. I wish Pakistan’s Chief Justice, Mohammad Iftikhar
Chaudhari, who did a brilliant job in upholding his country’s constitution in letter and spirit, had taken up the matter suo motu before retiring a few days ago. Many lawyers may mock at the suggestion, but punishment to the 26/11 terrorists is a pre-requisite to normal ties between the two
countries.

Hafeez Sayeed, who India suspects to be the mastermind behind the plan to attack Mumbai and has been let off by the Pakistan court for lack of evidence, is urging a jihad against India. It may sound ridiculous but many on this side believe that he has a hand in shaping Pakistan’s policy against India.

Despite these minus factors, the common man in India has warmth for Pakistan. Visitors returning from Pakistan endlessly talk about the hospitality and affection they received. Similar is the talk of love and generosity by the Pakistanis visiting India. Therefore, the blame is on the politicians and bureaucrats for not burying the hatchet. They seem to have developed a vested interest in keeping the two countries distant. I find the same faces of politicians and bureaucrats, even after their retirement, are engaged in Track II dialogue.

One Pakistani bureaucrat with a similar thinking briefed the press the other day on Prime Minister Nawaz Sharif’s warning that Kashmir could trigger a fourth war between India and Pakistan. Nawaz Sharif’s office issued a contradiction soon enough. But the damage had already been done. Prime Minister Manmohan Singh, otherwise a mature politician, too reacted in an irresponsible manner. He said that “Pakistan could not win a war against India during his lifetime.” I suspect his reaction was meant to show “strength” in view of forthcoming parliamentary elections.

What the Prime Minister or the Congress party he represents do not realise is that even the Bharatiya Janata Party
(BJP) has stopped raising the anti-Pakistan bogey because there is lessening response from the public. Some in the party or outside may be carrying the baggage of history, India’s partition in August 1947. But the anti-Pakistan line does not sell any longer.

A wrong propaganda is sought to be made in Pakistan that the Indian media indulges in bashing it. This is not true. However, I wish there were more stories about Pakistan in the Indian media. But then the governments in both the countries are to blame. They have given visas only to one news agency and one newspaper. There is one television channel which adopts a war-like posture. But India has some 300 channels report Pakistan as they do about other countries. Where do we go from here? The two countries can join hands in fighting against the terrorists. Nawaz Sharif has made a specific proposal that the two countries should institutionalise a mechanism of meetings between their national security advisers to discuss terrorism. At last, the two countries have had a meeting of directors general of military operations
(DGMOs) of the two countries to ensure the sanctity of the Line of Control
(LoC) in Jammu and Kashmir. This is a development in the right direction. Still what is important at this juncture is how to inspire the two countries to trust each other. Nawaz Sharif has rightly said that the real reason for estrangement is the “trust deficit” between the two countries. Many in Pakistan believe that the core problem is Kashmir. This is only a symptom, not the disease. Even if we manage to solve the Kashmir problem, some other problem would crop up if there is no trust.

The two nations are rightly conscious of the destruction the nuclear weapons, which they possess, can cause. Hence they should solve their differences peacefully. This policy came to be adopted for the first time at Tashkent after the 1965 war between the two countries. The then Indian Prime Minister, Lal Bahadur
Shastri, was insistent on adopting peaceful methods in sorting out their problems. Pakistan’s Martial Law Administrator at the time, General Mohammad
Ayub, said that the requirement was met by referring it to the UN Charter. The draft joint statement carried the same words. Shastri made Ayub write “without resorting to arms”.

Islamabad has stated that the responsibility of honouring the LoC lies with the two governments. The reported reaction by New Delhi is that the LoC is a military matter, not a political issue. Had this response come from Pakistan, where the army has a major say, it would have been understandable. How can a democratic India say that the armies on the two sides could decide it?

The LoC was firmed up at Shimla in a meeting between Prime Ministers Indira Gandhi and Zuflikar Ali Bhutto. The army commanders only demarcated on the ground the lines indicated in the agreement between the political masters. New Delhi should ponder over its stance once again so that the two countries move forward to normalise relations.

Is
it only me or does everybody have a polythene bag full of other polythene bags somewhere in the house?’ This question came up the other day on one of the emails doing the rounds. I could only sheepishly nod. I mean how can you just throw away a perfectly good polythene bag? Plus, what is more practical? The polythene bag which can be used ‘n’ number of times or the unreliable paper bag that can let you down at the most crucial time? Ever since a sturdy looking paper bag let a gobhi-aloo lunch leak an oily map of Africa on my new jeans, I haven’t quite forgiven it.

So I do keep that bursting-at-the-seams polythene bag for purposes as diverse as wrapping lunch boxes, storing my veggies, and stuffing it up a dripping tap. I’ve even heard from friends that they are effective gloves while hennaing hair. Every time I hear there will be a ban on polythene bags I spend a few sleepless nights, dreaming of a barren, polythene-less world. But then normalcy returns with everybody turning a blind eye to the ban.

We the great Indian middle class have also developed opening gifts without tearing the wrapping paper into a fine art. Usually the one with the nimblest fingers in our family does it while the rest hold their breath, pointing out devious sticking tapes in hushed tones. We cheer when the job is done, I smooth the paper out, fold it lovingly and send it to join its cousins under the mattress, all set for the sudden gifting opportunity.

The underside of the mattress is another story. It will never be an income-tax raider’s delight, but for us the annual turning of the mattresses is usually a journey down memory lane. This year I found a massive handmade card with an adventurously coloured drawing of a cake which no master chef could ever replicate. It took me back to the giggling girls of Class VI who had handed it to me and confided that though the card said ‘From Class VI’, the boys hadn’t helped at all. Gender wars, I realised, start rather early these days.

Anything old or apparently useless can be put to some use somehow, we believe. I still have Sonny’s long abandoned craft project — an intricate pattern of tiny rooms on a chart paper that was supposed to take the shape of a palace. Even though Sonny has long outgrown craft projects I don’t have the heart to throw it out. What if he suddenly gets that creative urge again?

Then there are the beautiful calendars of bygone years, flattened and saved in the hope one day inspiration will strike to turn them into a collage with the old ‘zari’ border, which itself has been waiting for a similar inspiration. The same reason is behind my stash of a hundred pre-facebook era greeting cards — those obsolete bits of paper with cartoons or dewy roses on the outside and mushy sentiment inside. I also hang onto them in the hope that someday they would be collectors’ items worth millions.

Healthcare for veterans, by veterans
Under the Ex-servicemen’s Contributory Health Scheme, one polyclinic has been opened in every district of the country. But a lot more needs to be done to help the growing community of defence veteransBrig M.L. Kataria (retd)

A historic decision was taken by the Government of India, Ministry of Defence, in December 2002 to provide comprehensive health care to 10 million ex-servicemen and their entitled dependants, through Ex-servicemen’s Contributory Health Scheme (ECHS), which was launched in January 2004. There is no parallel to this gigantic healthcare project for ex-servicemen and their entitled dependants.

The Scheme was envisaged to provide an ECHS polyclinic in every district of the country. To start with a total of 227 polyclinics, 104 in military stations and 123 in non-military stations, were established. Over the years 200 more polyclinics have been added. Thus, there are 427 polyclinics scattered all over the country. This number will further increase.

In order to take off the workload on military hospitals, nearly one thousand private/civil hospitals and diagnostic and specialty centres have been empanelled across the country for referral of patients by the ECH polyclinics annually and about one million have been referred for diagnosis, treatment and admission annually to the empanelled centres.

The annual budget outlay of the Ministry of Defence for ECHS is Rs 1,500 crore, which will escalate with each passing year. Therefore, an in-depth review of the functioning of ECHS for the last ten years is necessary.

Review committee

The ECHS needs a review in toto, including the type and functioning of the polyclinics, the requirement and composition of the regional directorates, empanelment of private/civil hospitals, specialty and diagnostic centres and their rate structures.

The proposed review committee should have experts from various fields like medical, finance, management, bio-medical equipment and
ex-servicemen.

The current ECHS has categorised three types of polyclinics — A,B and C, depending upon the estimated ESM beneficiaries of the polyclinic. Each polyclinic, irrespective of the number of clientele, should have all the basic investigative facilities for primary health care, namely, x-ray machine, a laboratory equipped for all routine tests, like blood sugar, kidney and liver function tests, lipids and haemogram, an ECG machine and a dental unit, with technicians to operate these facilities. Therefore,
any classification of polyclinics is not desirable. Consultants for various specialties like cardiology, ophthalmology, ENT, orthopaedic and gynaecology should be available for weekly visits to each polyclinic on a regional basis.

All polyclinics are located in district towns and cities. Therefore, these polyclinics are useful for ESM residing in towns and cities. Most of the ESM reside in the far-flung villages. For them, it is an arduous journey to and back from the polyclinic, particularly for those who are ill or disabled. It may take them a whole day to come back home. Therefore, there is necessity for a mobile medical service, a van fitted with a stock of essential medicines, facility to draw blood samples, to reach each of the villages once a week for a doorstep-delivery service. This will also considerably reduce the daily work load of each polyclinic.

To improve the quantum and quality of service and doctor-patient relationship, each polyclinic should have a consultant committee consisting of retired officers and other ranks, dependant on the polyclinic to meet the doctors of the polyclinic periodically, at least once in three months, for a bilateral consultation for smooth functioning of the system.

The veteran’s wing

The financial burden of reimbursement to a thousand civil/private hospitals, specialty and diagnostic centres during the last ten years may reveal that addition of a veterans' wing to the existing military hospitals, with their own medical staff will be more cost effective in the long run. In due coarse, veterans' hospitals and specialty, diagnostic centres, scattered across states, as the requirement arises, needs consideration.

Also, there is a serious dearth of pharmacists, lab and x-ray technicians. There is requirement for a central training institute to cater to the requirement of ECHS polyclinics for these technologists.

Age limit for veteran doctors who wish to join veterans' health care establishments should be relaxed. A doctor is professionally fit enough till the age of 75 to 80 years. They are doing so in their private practice and are attracting large number of patients every day. Arrangements can be made for the veterans with medical institutions and colleges for a few short up-date courses for each specialty. In USA and some other
countries, doctors well above 80 years are seen working in certain specialties in the hospitals.

Smart cards

As a part of terms of service, veterans are entitled to free medical aid for themselves and their dependants. Therefore, a levy for any contribution for a post-retirement medical aid is undesirable. Also, the documentation process to enroll for a membership of ECHS is so complicated and procedures are so cumbersome, they are beyond the scope of an average other rank or a widow. Issue of a smart card is a long process and
may take months. These can surely be simplified with modern management techniques.

At the time of retirement, the veteran is given his/her identity card by the regimental centre. Entire documentation for membership of ECHS and issue of the smart card can also be arranged and issued along with the identity card. This will reduce avoidable work load on the local station headquarter.

The smart card itself needs a relook. It is too small and prone to be lost or misplaced. Issue of a duplicate card is more cumbersome and takes much longer time than the original one. A much bigger and easily readable Smart Card for the veteran, who often suffer from low vision, needs consideration.

Non-pensioner veterans can avail of medical aid at military hospitals, but cannot become members of ECHS. Let us be generous and sympathetic to these step-sons also.

Need for super-specialty

ECHS is essentially a health care package. From top to the ECHS polyclinic level, one comes across more non-medical personnel than the professionals. There are not many competent doctor-administrators available. Therefore, at an ECHS polyclinic functional and hierarchical inconvenience is not avoidable. Surely health care personnel can also manage health care delivery.

There are a large number of veterans available, seeking re-employment. Therefore ECHS from top down to the polyclinic level should be manned by veterans for veterans.

Medical science and technology has advanced tremendously during the last few decades. The old concept of a general hospital, equipped with conventional technology to treat routine ailments under broad medical and surgical divisions, including gynaecology and ophthalmology is gradually developing specialties and super-specialties centres. These centres have been located in the general hospital complexes. This system adds considerably to the central administrative complex of the general hospital. Therefore, independent specialty and super-specialty centres have cropped up, like cardiac centres, eye centres, joint replacement and spinal injury centres, cancer management centres.

ECHS polyclinics are referring their patients to some of the empanelled centres with swollen bills for payment. Veterans health care may have to consider their own such centres in due course of time. A financial analysis may reveal that veterans' own specialty centres may prove to be less expensive than what we have to reimburse to the civil/private specialty centres. There is no dearth of professionals trained in these specialties in India. Most of the required bio-medical equipment for these specialties is now being manufactured in India. Therefore we need not drain out our funds and professionals.

Healthcare NGOs

There are a number of healthcare NGOs in India, who would be glad to collaborate with ex-servicemen's healthcare schemes, for the love of the veterans. They generate their own funds and resources for healthcare of the needy segment of society. They will therefore not only share the financial load but professional and administrative work load of ECHS. These NGOs can collaborate in many ways. They may establish and operate certain ECHS polyclinics.

They may operate mobile medical facilities in far flung rural areas. They may establish and operate old age homes for veterans. The Defence authorities who are controlling the ECHS at all levels need not be shy of collaborating with such patriotic NGOs to let them share their financial and functional work load.

In every state in India, veterans residing in cities and towns are often left alone and forlorn. Their children, as they grow up, have to go elsewhere in India or abroad, wherever they find employment. It is not easy to find domestic aid or attendants. The problem is faced by even the veterans settled in rural areas. There is a gradual erosion of joint family system for various reasons. Their plight is worse than that of their colleagues in cities and towns.

There is requirement for veterans' old age cum nursing homes in every state. Their number and location would vary from state to state to cater for their needy veterans.

This requirement needs priority in the long term planning for veterans’ welfare.

Veterans too need to volunteer to man all projects for healthcare. Therefore there should be no age limit for them. They should be encouraged and allowed to work as long as they can. There is no dearth of such volunteers on whom time hangs heavily and who wish to work. With good pension and a home to live, children settled, they don't crave for more money, but want some constructive engagement, if only the age bar is lifted. The authorities concerned at all levels have only to sound a trumpet for them to come forward.

Growing concerns

The armed forces are growing in all respects. At present, there are 10 million veterans and their dependants to be looked after.

This number may swell to 15 million in another three to four decades.

Besides healthcare, veterans have scores of other problems — financial, legal, educational, and most importantly of re-employment.

This calls for a separate veterans' department in the Ministry of
Defence.

The writer (94) is a doctor and an activist for veterans’ welfare. He helped establish and operate a veterans' polyclinic in Mohali for nine years, in collaboration with the Western Command, before the advent of the present ECHS polyclinic on the same premises.